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DHS reports expanded behavioral-health access and steep reductions in ASH forensic backlog
Summary
DHS briefed senators on Medicaid behavioral-health transformation: an expanded provider network, a beneficiary support helpline and a major reduction in Arkansas State Hospital’s overdue forensic evaluations—from 465 overdue cases at the start of reforms to 92 actionable overdue cases—credited to contracting with community mental health centers and operational changes.
Department of Human Services officials told the Senate Public Health Committee that Medicaid behavioral-health transformation has expanded access across the state and that reforms at Arkansas State Hospital (ASH) have dramatically reduced a backlog of forensic evaluations.
Jay Hill, who works in DHS’s Division of Aging, Adult and Behavioral Health Services, said the agency launched a beneficiary support and behavioral-health helpline and added outpatient behavioral-health services to Medicaid, including infant mental health (dyadic services for children under 4 and a parent). Hill said the number of independently licensed clinicians certified under the new program rose from 31 in February 2017 to 292, and behavioral-health agencies increased from 253 to 312.
Hill and Patricia Gann emphasized gaps remain in some rural counties but credited legislative changes and contract adjustments for expanding the network. “We have an expanded network,” Hill said, while acknowledging the state still needs to grow capacity in parts of the Delta and other rural areas.
Forensic evaluation reforms: Jimmy (Jay) Hill and the state hospital’s forensic staff described operational changes at ASH to manage a historically large forensic-evaluation caseload. ASH receives roughly 2,000 forensic-evaluation orders a year. DHS reported it reduced its overdue-evaluation backlog from 465 overdue evaluations (defined as 60 days past assignment) to 92 actionable overdue evaluations in less than a year. The hospital now reports 450 open cases, 360 of which are actionable, and said it has completed more evaluations than it received for 12 consecutive months.
Officials attributed the gains to improved data, new dashboards, better scheduling and incentives for community mental health centers to complete evaluations in a timely manner; they also created four case-manager positions and added legal staff to coordinate with courts. The hospital said it will seek additional funding to sustain community mental-health center contracts while finishing backlog elimination.
Why it matters: Expanded Medicaid coverage of behavioral-health and substance-use services and the forensic backlog reduction affect court processes, jail populations and community treatment options. Senators asked for county-level lists of under-served areas and metrics on how many certified providers are actively seeing clients rather than only being certified.
What’s next: DHS agreed to provide lists of counties with reduced access, numbers showing providers accepting new clients, and additional data on forensic investigations and outcomes; department leaders said they will return with follow-ups and funding requests as needed.
